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STEP 4. ACKNOWLEDGMENT <br />In order to qualify for this authority to serve beer and wine, the following guidelines must be met: <br />1. There must be a wall defined premises, i.e. building, lent, enclosure, or fenced -in or designated area. <br />2. You must have a defined floor plan or diagram. This is to be drawn on Page 1, Step 3 of this application. If minors are to be present, you must have <br />a defined separation between the bar area and family area. (Must be on floorplan.) <br />3. There shall be NO carry -out privileges, NO carry -in privileges and NO spirituous beverages allowed. <br />4. Each applicant must designate an individual to be responsible for the event and such person shall sign the authority. <br />5. ANY and ALL persons dispensing or accepting payment for alcoholic beverages MUST POSSESS a valid ATC employee permit. <br />6. The event must meet applicable Indiana State Board of Health requirements, padicularly with regard to restroom facilities. <br />7. If the event is held in a town park. you must have approval from the town board. <br />S. Legal Hours of dispensing alcoholic beverages: (Prevalling time) <br />Monday through Saturday — 7 AM to 3 AM the following day <br />Sunday -- 7 AM to 3 AM the following day <br />9. Applicant must file with the district office at which the event will be held at least five (b) days prior to the event. <br />10. The authority must be posted in the most conspicuous place at the location of the event. An excise officer or commissioner, for good cause, has the <br />authority to revoke the authority during the event. <br />STEP S. COMMUNITY CLEARANCE <br />1. Sign re or h//erilf of ly, or Chief arT Mai of (urisdlGian where the event will be held <br />Care signed fnbnih, day, year) <br />V <br />2. Signature of the mayor tirlhe event is held in F ) <br />Date signed (month, day, year) <br />Note: <br />Please post your approved request in a conspicuous place where the alcoholic beverages are being dispensed at the location. <br />If for any reason this request is denied, you may be notified either in person or by telephone. <br />I swear or affirm under penalties of perjury that the information is true and accurate. <br />SignaVtr6af perrPi /agent Signa u aotm that you hem read and wrl abide by the rules and guidelines.) <br />Dab sigapd mond, Vey. year) <br />FOR DISTRICT USE ONLY <br />District number <br />Dab issued (mon M, day. year) <br />Reviewed by Exdse PdK Dis ' 1 <br />Approved ❑ Denied <br />M2 <br />Page 2 of 2 <br />